Individual
NICHOLAS W MOROG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
6518 MEADOWRIDGE RD, SUITE 110, ELKRIDGE, MD 21075-6403
(410) 368-8650
(410) 368-8655
Mailing address
6518 MEADOWRIDGE RD STE 110, ELKRIDGE, MD 21075-6458
(667) 234-8650
(667) 234-8655
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
D0050812
MD
208000000X
Pediatrics Physician
D0050812
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0021
CAREFIRST-DC
MD
05
—
520590500
—
MD
Enumeration date
03/23/2006
Last updated
04/27/2018
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